BEFORE THE MADURAI BENCH OF MADRAS HIGH COURT
R.VIJAYAKUMAR, J.
ICICI Lombard General Insurance Limited - Appellant
Vs.
Lakshmana Mudaliar Selvakani - Respondent
C.R.P.(NPD)(MD).No.379 of 2025
Decided On : 01-04-2025
(A) Consumer Protection Act, 1986 - Section 51 - Delay in filing appeal - The appellant challenged the dismissal of their application for condonation of delay of 101 days in filing the first appeal against the repudiation of an insurance claim. The National Commission dismissed the application, citing the appellant's administrative capacity and the absence of sufficient cause for delay. (Paras 1, 5, 19)
(B) Sufficient Cause - The court emphasized that the delay must be evaluated with a view to advance substantial justice, and the reasons provided by the appellant were deemed reasonable. (Paras 20)
(C) Pre-existing Condition - The insurance company denied the claim based on pre-existing conditions, which the court found necessary to consider in the context of the appeal. (Paras 8, 19)
Facts of the case:
The respondent purchased an insurance policy and later filed a claim after undergoing medical treatment for a condition related to pre-existing diseases. The claim was repudiated by the insurance company, leading to a consumer complaint.
Findings of Court:
The court found the reasons for the delay in filing the appeal to be reasonable and set aside the dismissal of the condonation application.
Issues: The main issue was whether the appellant had established sufficient cause for the delay in filing the appeal.
Ratio Decidendi: The court ruled that the reasons for the delay were reasonable and should be considered to ensure substantial justice is served.
Result: The civil revision petition is allowed, and the delay in filing the appeal is condoned.
ORDER :
R.VIJAYAKUMAR, J.
The appellant in the First Appeal No.795 of 2024 on the file of the National Consumer Disputes Redressal Commission, New Delhi has filed the present revision petition challenging the dismissal of their application for condonation the delay of 101 days in filing the first appeal.
2.The respondent herein has purchased Overseas Insurance Policy for himself and his wife from the petitioner insurance company for a sum of 1,00,000 U.S.Dollar. According to the complainant, at the time of taking policy, he had furnished all his personal records and medical records of his wife. The policy was issued on 16.06.2018 covering the period between 24.06.2018 and 14.12.2018. When the respondent was at San Francisco, USA, on 12.11.2018 he felt discomfort and he was admitted to the hospital where he was diagnosed that he was affected with hypertension due to coronary artery disease. On 12.11.2018, he was given coronary angioplasty with stent replacement. After following medical care, he was discharged. He had submitted his claim form to the petitioner insurance company on 14.03.2019.
3.The petitioner/Insurance Company had repudiated the claim on the ground that coronary artery disease has arisen from the pre-existing condition of diabetes mellitus and hypertension which are strong risk factors. The Insurance Company referred to the exclusion clause of 2.1.4 and stated that any claim due or arising of precondition whether declared or undeclared is not covered under the policy. Aggrieved over repudiation, the respondent has filed a consumer complaint in C.C.No.27 of 2019 before the Tamil Nadu State Consumer Disputes Redressal Commission (TNSCDRC), Madurai Bench.
4.The State Commission after considering the submissions on either side, rejected the defence of the Insurance Company and proceeded to pass an order directing the insurance company to pay a sum of Rs.69,80,000/- towards insured amount along with 6% interest from the date of complaint till realisation. The opposite parties therein were directed to pay a sum of Rs.2,00,000/- towards compensation along with 6% interest. The opposite parties were further directed to pay a sum of Rs. 10,000/- towards costs. The above said order was passed by the Tamil Nadu State Consumer Disputes Redressal Commission, Madurai on 08.04.2024 and a copy of the order was received by the counsel on 25.04.2024.
5.As per Section 51 of the Consumer Protection Act, an appeal has to be preferred within a period of 30 days namely on or before 25.05.2024. However, the appeal was presented before the National Consumer Disputes Redressal Commission (NCDRC), New Delhi on 31.08.2024 with a delay of 101 days. The delay application was dismissed by the National Commission on the ground that the petitioner/Insurance Company is having technically competent and well qualified persons on their rolls and strong administrative set-up and therefore, condoning such delay would not be in letter and spirit of the Consumer Protection Act, 1986. Challenging the same, the present revision petition has been filed.
6.According to the learned senior counsel appearing for the petitioner, the order copy was received through post by the learned counsel appearing for the insurance company on 25.04.2024 and the appeal ought to have been presented before 25.05.2024. As per applicable rules, the appeal has to be presented along with certified copies of all the documents which were marked on either side before the State Commission. The free certified copy sent by the State Commission was misplaced by the lawyer in his office. That apart, the records were incomplete and they were not able to locate the records. After spending sometime, an application was filed before the State Commission for furnishing certified copies of the records on 12.07.2024 and the certified copies were made ready on 12.07.2024. However, it was found that the record was incomplete to the effect that the documents filed on the side of the insurance company have
The court emphasized that sufficient cause for delay in filing an appeal must be evaluated to advance substantial justice, overriding strict adherence to timelines.
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